Today’s earnings report from Gilead Sciences will be closely watched on both Wall Street and Capitol Hill, where the argument about how much the world’s second-most-valuable biotech company should charge for its new $84,000 hepatitis C drug Sovaldi is getting more and more heated. For most people, though, the arguments that matter aren’t about whether Gilead beats rumor-mill estimates that it may have sold $4 billion of Sovaldi this past quarter. The reader mail that came in when I wrote about my own experience as one of the first Sovaldi patients in April is all about the new consumer-medical world Sovaldi heralds: patients pay more of the bill, consumers shop and bargain to hold down costs, and the phrase “insurance covers it” will drive ever-fewer decisions.